
<?php 
  /**
   * Desarrollado por Yasmin Vicuna de Pena
   */
?>

<table style="width:630px" border="0" cellspacing="3" cellpadding="0"  >
	<tr><td colspan="4">
		<div class="ui-widget" style="display:none;" id='divListaCreditos'>
			<div class="ui-state-highlight ui-corner-all" style="margin-top: 10px; padding: .8em;" id='divListaCreditosInformacion'>
						
			</div>
		</div>
		<br>
	</td></tr>
	<tr>
		<td style="width: 220px;" >C&eacute;dula (*):</td>
		<td style="width: 185px;" align="left" >
			<select name="txtNacionalidad" id="txtNacionalidad"  class="inputxt" style="width: 50px;">
				<option>V-</option>
				<option>E-</option>
			</select>
			<input name="txtCedula" type="text"  class="inputxt" style="width: 125px;" id="txtCedula" onblur="consultar_clientes('<?php echo __LOCALWWW__?>');">
		</td>
		<td style="width: 120px;">Estado Civil:</td>
		<td align="right">
			<select name="txtEdocivil" id="txtEdocivil" class="inputxt" style="width: 150px;" >
			<option>SOLTERO (A)</option>
			<option>CASADO (A)</option>
			<option>DIVORCIADO (A)</option>
			<option>VIUDO (A)</option>
		</select></td>
	</tr>
	<tr>
		<td> Nombres: </td>
		<td align="left"  colspan=3 >
			<input name="txtNombre1"	type="text" id="txtNombre1" class="inputxt" style="width: 180px;">
			<input name="txtNombre2"	type="text" id="txtNombre2" class="inputxt" style="width: 306px;">
		</td>
 </tr>
 <tr>
		<td > Apellidos:</td>
		<td align="left" colspan=3 >
			<input name="txtApellido1" type="text" id="txtApellido1" class="inputxt" style="width: 180px;">
			<input name="txtApellido2" type="text" id="txtApellido2" class="inputxt" style="width: 306px;">
		</td>
	</tr>
	<tr>
		<td >Fecha nacimiento:</td>
		<td align="left" ><select name="txtDiaNacimiento" id="txtDiaNacimiento" class="inputxt" style="width: 55px;">
			<option>Dia:</option>
			<?php 
				for($i = 1; $i <= 31; $i++){
			?>
				<option value='<?php echo $i ?>'><?php echo $i ?></option>
			<?php 
				}
			?>
		</select>
		<select name="txtMesNacimiento"	id="txtMesNacimiento" class="inputxt" style="width: 55px;">
			<option>Mes:</option>
			<?php 
					for($i = 1; $i <= 12; $i++){
			?>
				<option value='<?php echo $i ?>'><?php echo $i ?></option>
			<?php 
				}
			?>
		</select>
		<select name="txtAnoNacimiento"	id="txtAnoNacimiento" class="inputxt" style="width: 65px;">
			<option>A&ntilde;o:</option>
				<?php 
					for($i = 1900; $i <= 2014; $i++){
			?>
				<option value='<?php echo $i ?>'><?php echo $i ?></option>
			<?php 
				}
			?>
		</select></td>
		<td >Identificaci&oacute;n del Sexo:</td>
		<td align="right" ><select name="txtSexo" id="txtSexo" class="inputxt"	style="width: 150px;">
			<option selected="selected">MASCULINO</option>
			<option>FEMENINO</option>
		</select></td>
	</tr>
	<tr>
		<td >Cargo:</td>
		<td align="left">
			<input name="txtCargo" type="text" style="width: 180px;" class="inputxt" id="txtCargo">
		</td>
				<td >N&uacute;m. Tel&eacute;fono:</td>
		<td align="right" >
			<input name="txtTelefono" id="txtTelefono" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
	<tr>
		<td >Municipio:</td>
		<td align="left" >
			<input name="txtMunicipio"		type="text" id="txtMunicipio"  class="inputxt" style="width: 180px;">
		</td>
		<td >Edificio:</td>
		<td align="right" >
			<input name="txtParroquia" id="txtParroquia" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
	<tr>
		<td >Ubicaci&oacute;n Sector :</td>
		<td align="left" >
			<input name="txtSector"		type="text" id="txtSector"  class="inputxt" style="width: 180px;">
		</td>
		<td >Avenida.:</td>
		<td align="right" >
			<input name="txtAvenida" id="txtAvenida" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
		<tr>
		<td >Urbanizaci&oacute;n:</td>
		<td align="left" >
			<input name="txtUrbanizacion"		type="text" id="txtUrbanizacion"  class="inputxt" style="width: 180px;">
		</td>
		<td >Calle.:</td>
		<td align="right" >
			<input name="txtCalles" id="txtCalles" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
	<tr>
		<td >Casa y/o Apto N&uacute;m.:</td>
		<td align="left">
			<input name="txtDireccionH"  id="txtDireccionH" type="text" class="inputxt" style="width: 180px;">
			
		</td>
		
				<td >Zona Postal.:</td>
		<td align="right" >
			<input name="txtZonaPostal" id="txtZonaPostal" type="text" class="inputxt" style="width: 150px;" ondblclick="muestra_zona_postal()">
			<div id="divZonaPostal" title="SELECCIONE UN CODIGO POSTAL"><table><tr><?php echo $estados;?></tr><tr><td><label>ZONA POSTAL</label></td><td><select id="cmbZonas"></select></td></tr></table></div>
		</td>
	</tr>
		<tr>
		<td >Direcci&oacute;n Trabajo:</td>
		<td align="left" colspan="3">
			<input name="txtDireccionT"  id="txtDireccionT" type="text" class="inputxt" style="width: 490px;">
			
		</td>
	</tr>
	
	<tr>
		<td >Ciudad:</td>
		<td align="left" >
			<input name="txtCiudad"		type="text" id="txtCiudad"  class="inputxt" style="width: 180px;">
		</td>
		<td >Estado: </td>
		<td align="right" >
			<input name="txtUbicacion" id="txtUbicacion" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
<!--	<tr>-->
<!--		<td >Fe de vida</td>-->
<!--		<td  align="left">-->
<!--			<input type="radio"	name="txtFedeVida" id="txtFedeVida" value=1>&nbsp;Si &nbsp;&nbsp; -->
<!--			<input type="radio" name="txtFedeVida" id="txtFedeVida" value=0 checked>&nbsp;No</td>-->
<!--		<td  align="left">Titular:</td>-->
<!--		<td  align="left"><input type="radio"-->
<!--			name="txtTitular" value=1 id="txtTitular">&nbsp;Si &nbsp;&nbsp; <input-->
<!--			type="radio" name="txtTitular" value=0 checked>&nbsp;No</td>-->
<!--	</tr>-->
<!--	-->
<!--	<tr>-->
<!--		<td >Copia CI</td>-->
<!--		<td  align="left">-->
<!--			<input type="radio"	name="txtCopia" id="txtCopia" value=1>&nbsp;Si &nbsp;&nbsp; -->
<!--			<input type="radio" name="TxtCopia" id="txtCopia" value=0 checked>&nbsp;No</td>-->
<!--		<td  align="left">Copia Libreta:</td>-->
<!--		<td  align="left">-->
<!--		  <input type="radio"	name="txtLib" id="txtLib" value=1 />&nbsp;Si &nbsp;&nbsp; -->
<!--		  <input type="radio" name="txtLib" id="txtLib" value=0 checked>&nbsp;No</td>-->
<!--	</tr>-->
<!--	-->
<!--	<tr>-->
<!--		<td >&nbsp;</td>-->
<!--		<td >&nbsp;</td>-->
<!--		<td >&nbsp;</td>-->
<!--		<td >&nbsp;</td>-->
<!--	</tr>-->
<!--	<tr>-->
<!--		<td >Nivel Acad&eacute;mio:</td>-->
<!--		<td  align="left"><select name="txtNivelAcademico" id="txtNivelAcademico" style="width: 130px;">-->
<!--			<option selected="selected">BACHILLER</option>-->
<!--			<option>T.S.U.</option>-->
<!--			<option>UNIVERSITARIO</option>-->
<!--		</select></td>-->
<!--		<td >&nbsp;</td>-->
<!--		<td >&nbsp;</td>-->
<!--	</tr>-->

	  <tr>
		<td>Banco (Nomina)</td>
		<td align="left" style="width: 165px;">
			<select	name="txtbanco_1" id="txtbanco_1" class="inputxt" style="width: 180px;" onchange="verifica_banco(this);" >
				<option>----------</option>
				<option>SOFITASA</option>
				<option>BICENTENARIO</option>
				<option>BOD</option>
				<option>PROVINCIAL</option>
				<option>VENEZUELA</option>
				<option>BANESCO</option> 
				<option>INDUSTRIAL</option>
				<option>MERCANTIL</option>
				<option>CAMARA MERCANTIL</option>
				<option>EL EXTERIOR</option>
				<option>FONDO COMUN</option>
				<option>DEL SUR</option>
				<option>FEDERAL</option>
				<option>CANARIAS</option>
				<option>CARONI</option>
				<option>CARIBE</option>
				<option>PLAZA</option>
				<option>CENTRAL</option>
				<option>NACIONAL DE CREDITO</option>
				<option>COMERCIO EXTERIOR</option>
				<option>OCCIDENTAL DE DESCUENTO</option>
				<option>100% BANCO COMERCIAL</option>
				<option>BANCORO</option>
				<option>CORPBANCA</option>
			</select>
		</td>	

		<td  style="width: 110px;">Tipo de Cuenta: </td>
		<td align="right">
			<select
				name="txtTipo_1" id="txtTipo_1" class="inputxt" style="width: 150px;" >
				<option>----------</option>
				<option>AHORRO</option>
				<option>CORRIENTE</option>
				<option>AHORRO NOMINA</option>
				<option>CORRIENTE NOMINA</option>
			</select></td>		
		</tr>
		<tr>
			<td  >N&uacute;m. de Cuenta:</td>
			<td  colspan="3" align="left" >
			<input name="txtcuenta_1" type="text" class="inputxt" style="width: 490px;" id="txtcuenta_1" maxlength="20" onblur="Verificar_Cuenta(this.value);" onkeypress="Mayusculas(this);">
		</td>
	</tr>
	
	<tr>
		<td   >2.- Banco :</td>
		<td align="left" >
			<select
				name="txtbanco_2" id="txtbanco_2" class="inputxt" style="width: 180px;" onchange="verifica_banco(this);" >
				<option>----------</option>
				<option>SOFITASA</option>
				<option>BICENTENARIO</option>
				<option>BOD</option>
				<option>PROVINCIAL</option>
				<option>VENEZUELA</option>
				<option>BANESCO</option> 
				<option>INDUSTRIAL</option>
				<option>MERCANTIL</option>
				<option>CAMARA MERCANTIL</option>
				<option>EL EXTERIOR</option>
				<option>FONDO COMUN</option>
				<option>DEL SUR</option>
				<option>FEDERAL</option>
				<option>CANARIAS</option>
				<option>CARONI</option>
				<option>CARIBE</option>
				<option>PLAZA</option>
				<option>CENTRAL</option>
				<option>NACIONAL DE CREDITO</option>
				<option>COMERCIO EXTERIOR</option>
				<option>OCCIDENTAL DE DESCUENTO</option>
				<option>100% BANCO COMERCIAL</option>
				<option>BANCORO</option>
				<option>CORPBANCA</option>
			</select>
		</td>
		<td >Tipo de Cuenta: </td>
			<td align="right" >
				<select
				name="txtTipo_2" id="txtTipo_2" class="inputxt" style="width: 150px;" >
				<option>----------</option>
				<option>AHORRO</option>
				<option>CORRIENTE</option>
				<option>AHORRO NOMINA</option>
				<option>CORRIENTE NOMINA</option>
			</select></td>

		</tr>
		<tr>
			<td  >N&uacute;m. de Cuenta:</td>
			<td colspan="3">
			<input name="txtcuenta_2" type="text" class="inputxt"  style="width: 490px;" id="txtcuenta_2" maxlength="20" />
		</td>

	</tr>
<!--	<tr>-->
<!---->
<!--		<td  >3.- Banco:</td>-->
<!--		<td align="left" >-->
<!--			<select-->
<!--				name="txtbanco_3" id="txtbanco_3" class="inputxt" style="width: 180px;" >-->
<!--				<option>----------</option>-->
<!--				<option>SOFITASA</option>-->
<!--				<option>BICENTENARIO</option>-->
<!--				<option>BOD</option>-->
<!--				<option>PROVINCIAL</option>-->
<!--				<option>VENEZUELA</option>-->
<!--				<option>BANESCO</option> -->
<!--				<option>INDUSTRIAL</option>-->
<!--				<option>MERCANTIL</option>-->
<!--				<option>DEL SUR</option>-->
<!--			</select>-->
<!--			-->
<!--		</td>-->
<!--			<td >Tipo de Cuenta:</td>-->
<!--			<td align="right" >-->
<!--				<select-->
<!--				name="txtTipo_3" id="txtTipo_3" class="inputxt" style="width: 150px;" >-->
<!--				<option>----------</option>-->
<!--				<option>AHORRO</option>-->
<!--				<option>CORRIENTE</option>-->
<!--				<option>AHORRO NOMINA</option>-->
<!--				<option>CORRIENTE NOMINA</option>-->
<!--			</select></td>-->
<!--	-->
<!--		</tr>-->
<!--		<tr>-->
<!--			<td  >N&uacute;m. de Cuenta:</td>-->
<!--			<td colspan="3">-->
<!--			<input name="txtcuenta_3" type="text" class="inputxt" style="width: 490px;" id="txtcuenta_3"/>-->
<!--		</td>-->
<!---->
<!--	</tr>-->


	<tr>
		<td >Correo:</td>
		<td align="left" >
			<input name="txtCorreo"		type="text" id="txtCorreo"  class="inputxt" style="width: 180px;">
		</td>
		<td >PIN (Celular):</td>
		<td align="right" >
			<input name="txtPin" id="txtPin" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
	
		<tr>
		<td >F. Ingreso:</td>
		<td align="left" >
		
			<select name="txtDiaI" id="txtDiaI" class="inputxt" style="width: 55px;">
				<option value='0'>Dia:</option>
				<?php 
					for($i = 1; $i <= 31; $i++){
				?>
					<option value='<?php echo $i ?>'><?php echo $i ?></option>
				<?php
			}
				?>
			</select>
			<select name="txtMesI"	id="txtMesI" class="inputxt" style="width: 55px;">
				<option value='0'>Mes:</option>
				<?php 
						for($i = 1; $i <= 12; $i++){
				?>
					<option value='<?php echo $i ?>'><?php echo $i ?></option>
				<?php
			}
				?>
			</select>
			<select name="txtAnoI"	id="txtAnoI" class="inputxt" style="width: 60px;">
				<option value='0'>A&ntilde;o:</option>
					<?php 
						for($i = 1950; $i <= 2014; $i++){
				?>
					<option value='<?php echo $i ?>'><?php echo $i ?></option>
				<?php
			}
				?>
			</select>


		</td>
		<td >Mes. Vacaciones: </td>
		<td align="right" >
		
			<select name="txtMesA"	id="txtMesA" class="inputxt" style="width: 150px;" >
				<option value=0>----------</option>
				<option value=1>ENERO</option>
				<option value=2>FEBRERO</option>
				<option value=3>MARZO</option>
				<option value=4>ABRIL</option>
				<option value=5>MAYO</option>
				<option value=6>JUNIO</option>
				<option value=7>JULIO</option>
				<option value=8>AGOSTO</option>
				<option value=9>SEPTIEMBRE</option>
				<option value=10>OCTUBRE</option>
				<option value=11>NOVIEMBRE</option>
				<option value=12>DICIEMBRE</option>
			</select>

		</td>
	</tr>
	
	<tr>
		<td >Monto Vac. 2011:</td>
		<td align="left" >
			<input name="txtVacaciones"		type="text" id="txtVacaciones"  class="inputxt" style="width: 180px;">
		</td>
		<td >Monto Agu. 2011:</td>
		<td align="right" >
			<input name="txtAguinaldos" id="txtAguinaldos" type="text" class="inputxt" style="width: 150px;">
		</td>
	</tr>
	
	
		<tr>
		<td >Tipo Personal</td>
		<td align="left" >
			<select name="txtPersonal"	id="txtPersonal" class="inputxt" style="width: 180px;" >
				<option value='0'>ACTIVO</option>
				<option value='1'>JUBILADO</option>
			</select>
		</td>
		<td >Afiliado:</td>
		<td align="right" >
			<select name="txtAfiliado"	id="txtAfiliado" class="inputxt" style="width: 180px;" >
				<option value='0'>NO (FIRMO)</option>
				<option value='1'>SI (ACEPTO Y FIRMO)</option>
			</select>
		</td>
	</tr>
	
</table>



